Outcomes of Out-of-hospital Cardiac Arrests After a Decade of System-wide Initiatives Optimising Community Chain of Survival in Taipei City,Resuscitation

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Outcomes of Out-of-hospital Cardiac Arrests After a Decade of System-wide Initiatives Optimising Community Chain of Survival in Taipei City
Resuscitation ( IF 6.5 ) Pub Date : 2021-12-28 , DOI: 10.1016/j.resuscitation.2021.12.027
Hao-Yang Lin , Yu-Chun Chien , Bin-Chou Lee , Yung-Lung Wu , Yueh-Ping Liu , Tzong-Luen Wang , Patrick Chow-In Ko , Kah-Meng Chong , Hui-Chih Wang , Edward Pei-Chuan Huang , Jen-Tang Sun , Ming-Ju Hsieh , Sheng-Wen Hou , Wen-Shuo Yang , Yao-Cheng Wang , Chien-Hua Huang , Wen-Chu Chiang , Matthew Huei-Ming Ma

Objective

A strengthened chain of survival benefits patient outcomes after out-of-hospital cardiac arrest (OHCA).² Over the past decade, the Taipei Fire Department (TFD) has continuously implemented system-wide initiatives on this issue. We hypothesised that for adult, non-trauma OHCA patients, the bundle of these system-wide initiatives are associated with better outcomes.

Methods

We conducted a registry-based, retrospective study to examine the association between consecutive system-level initiatives and OHCA survival on a two-yearly basis using trend analysis and multivariable logistic regression. The primary outcome was survival to hospital discharge (STHD) and favourable neurological status.

Results

We analysed 18,076 cases from 2008 to 2017. The numbers of two-yearly cases of OHCA with resuscitation attempts from 2008 to 2017 were 3,576, 3,456, 3,822, 3,811, and 3,411. There was a significant trend of improved STHD (Two-fold) and favourable neurological outcome (Six-fold) over the past decade. Similar trends were observed in the shockable and non-shockable groups. Considering the first 2 years as baseline, the odds of STHD and favourable neurological status in the end of the initiatives increased significantly after adjusting for universally recognised predictors for OHCA survival.

Conclusion

For non-trauma adult OHCA in Taipei, continuous, multifaceted system-wide initiatives on the community chain of survival were associated with improved odds of STHD and favourable neurologic outcomes.

中文翻译：

十年全系统优化台北市社区生存链后的院外心脏骤停结果

客观的

院外心脏骤停 (OHCA) 后，强化的生存链有益于患者的预后。²在过去十年中，台北消防局 (TFD) 一直在全系统范围内就这个问题实施举措。我们假设对于成人、非创伤性 OHCA 患者，这些全系统举措的捆绑与更好的结果相关。

方法

我们进行了一项基于注册的回顾性研究，使用趋势分析和多变量逻辑回归，每两年检查一次连续系统级举措与 OHCA 生存率之间的关联。主要结果是出院生存（STHD）和良好的神经系统状态。

结果

我们分析了 2008 年至 2017 年的 18,076 例病例。从 2008 年至 2017 年，每两年尝试复苏的 OHCA 病例数分别为 3,576、3,456、3,822、3,811 和 3,411 例。在过去的十年中，STHD（两倍）和良好的神经系统结果（六倍）有明显的改善趋势。在可电击组和不可电击组中也观察到了类似的趋势。以前 2 年为基线，在调整了公认的 OHCA 生存预测因子后，在计划结束时 STHD 和良好的神经系统状态的几率显着增加。